Acute and Critical Care Surgery at EUH

Acute and Critical Care Surgery at Emory University Hospital

The Division of General and GI Surgery's Acute and Critical Care Surgery (ACCS) service at Emory University Hospital (EUH) was implemented in 2010 as a quality improvement effort for EUH's Emergency Department (ED) and a new rotation opportunity for general surgery residents. Prior to that time, acute/emergent surgery needs in the EUH ED were responded to by an on-call general surgeon. The establishment of the ACCS, however, has provided the ED with a revolving surgical staff of on-site, general surgery faculty attendings assisted by resident teams.

Hospital data since the implementation of the ACCS has shown shortened response time to ED cases requiring surgery, decreased hospital length-of-stay, enhanced continuity of patient care, and lessening of the 30-day readmission rate. In-house surveys of ED and hospital medicine professional staff also indicate improved perceptions of the surgical management of ED patients. The ACCS is standardizing clinical care pathways for the primary surgical needs presenting in the ED, and streamlining the interactions among the multi-disciplinary ED shifts.

For Emory general surgery residents, who also rotate through the Level I Trauma Center and Burn Unit at Grady Memorial Hospital, the ACCS rotation gives an additional opportunity to work in the OR treating time sensitive, acute emergency cases and to be involved with the management of those cases post-procedure. Common conditions that present at the EUH ED requiring surgery are appendicitis, diverticulitis, cholelithiasis/cholecystitis, intestinal obstruction, and hernia.

The faculty attendings on the service are Dr. Wendy Greene, director of the service; Dr. David Elwood, the service's co-director; and Dr. Carla Haack. In addition to conducting incoming patient evaluations and performing procedures, the attendings and their resident teams make daily rounds, do patient follow-ups, and staff an official ACCS clinic once a week.